Long-Term Survival Is Superior in Patients With Pulsatile Pulmonary Flow After the Björk Procedure.

Klemm, Lukas; Schaeffer, Thibault; Heinisch, Paul Philipp; Staehler, Helena; Röhlig, Christoph; Meierhofer, Christian; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi

doi:10.1177/21501351231205568

2024

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Title:: Long-Term Survival Is Superior in Patients With Pulsatile Pulmonary Flow After the Björk Procedure.
Document type:: Journal Article
Author(s):: Klemm, Lukas; Schaeffer, Thibault; Heinisch, Paul Philipp; Staehler, Helena; Röhlig, Christoph; Meierhofer, Christian; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
Abstract:: Background: This study aims to evaluate clinical outcomes and hemodynamic variables late after the Björk procedure, regarding the pulmonary flow pattern. Methods: Patients who survived more than 15 years after the Björk procedure were included and then divided into two groups according to their pulmonary flow pattern by pulsed-wave Doppler assessment of echocardiography: patients with pulsatile systolic pulmonary flow (Group P) and those without (Group N). Results: A total of 43 patients were identified, of whom 13 patients were divided into Group P and 30 in Group N. Median age at the Björk procedure was 5.7 (2.1-7.3) years, and median follow-up was 32 (28-36) years. Survival after 15 years was higher in Group P, compared with Group N (100% vs 76% at 30 years, P = .045). Cardiac catheterization data demonstrated higher cardiac index in Group P patients compared with Group N patients (3.5 vs 2.8 L/m2, P = .014). Cardiac magnetic resonance imaging study revealed that Group P patients had higher right ventricular end-diastolic volume index (96 vs 57 mL/m2, P = .005), higher end-systolic volume index (49 vs 30 mL/m2, P = .013) and higher right ventricular stroke volume index (48 vs 25 mL/m2, P < .001), compared with Group N patients. Exercise capacity tests demonstrated that Group P patients showed a higher percent predicted peak oxygen consumption, compared with Group N patients (73 vs 58%, P < .001). Conclusions: Late after the Björk procedure, patients with a pulsatile systolic pulmonary flow had a larger right ventricle and better exercise capacity compared with those without pulsatile systolic pulmonary flow.
Journal title abbreviation:: World J Pediatr Congenit Heart Surg
Year:: 2024
Journal volume:: 15
Journal issue:: 1
Pages contribution:: 19-27
Fulltext / DOI:: doi:10.1177/21501351231205568
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/37990544
Print-ISSN:: 2150-1351
TUM Institution:: Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer); Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane); Klinik und Poliklinik für Urologie (Prof. Gschwend)
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